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Competitive Bidding: Once Again, It’s Back!

CEO SUMMARY: For the clinical lab industry, the concept of competitive bidding for Medicare Part B Clinical Lab Testing may be like the movie “Groundhog Day.” The hero, Bill Murray, kept reliving the same day over and over. So it seems to be with competitive bidding. In the latest rep…

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Hospital Labs Feel More Pressure to Lower Prices

CEO SUMMARY: It’s a new trend and gathering momentum. At managed care contract renewal time, more hospitals and health systems report much stronger pressure from health insurers to accept deep cuts to laboratory test prices. At the same time, managed care companies are getting smarter a…

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Quest Diagnostics and LabCorp Report Q-4, Full Year Earnings

IN RECENT WEEKS, each of the nation’s two largest public laboratory companies reported earnings for fourth quarter 2011 and full year 2011. Organic growth at both lab companies continues at low single-digit rates. This continues the pattern of relatively modest growth that has been posted by each …

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Today’s Lab Test Model Won’t Survive Reforms

CEO SUMMARY: For more than three decades, independent lab companies have waxed fat by increasing their respective market share of lab test referrals from office-based physicians. This era is poised to end as growing numbers of office-based physicians begin to practice medicine within an a…

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Does Anyone Know the Law in California?

WHAT IS THE LAW IN CALIFORNIA THAT DEFINES PROVIDER PRICING and how Medi-Cal should be billed? You probably think that question would be rather easy to answer after you read one of the state statutes that governs pricing relative to Medi-Cal claims. Popularly known among the lab industry as 51501(a),…

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LabCorp Inks Agreement In Medi-Cal Pricing Case

CEO SUMMARY: In its “Settlement Agreement and Release” with the California Attorney General (AG), Laboratory Corporation of America has negotiated terms that essentially match the agreement that exists between Quest Diagnostics Incorporated and the California AG. These settle…

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Why Insurers Are Buying Office-Based Physicians

WHEN THE NEWS BECAME PUBLIC earlier this month that UnitedHealth Group was quietly purchasing physician groups in selected areas of the country, there was a flurry of news articles recognizing this as a new trend. These news stories came after July 1. That’s the date when Kaiser Health N…

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Quest Diagnostics and LabCorp Report Second Quarter Earnings

JUST ONE DAY APART, the nation’s two largest laboratory testing companies reported second quarter and half-year earnings for 2011. Each financial report opened a window into marketplace developments for the first six months of this year. First to release its earnings report was Quest Diagn…

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What Comes Next in Battle Over Discount Lab Prices?

CEO SUMMARY: Now that the settlement involving Quest Diagnostics Incorporated and the California Attorney General has been announced, attention turns to what comes next with the four remaining defendant lab companies in the whistle-blower lawsuit. There are several different scen…

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Understanding the Deal With Medi-Cal and Quest

CEO SUMMARY: It is now possible to see the specific language in the “Settlement Agreement and Release” document executed by the California State Attorney General and Quest Diagnostics Incorporated. For those clinical lab managers—and the attorneys who represent their labora…

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